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severe anemia developed earlier than two years after the operation. Our case also has shown this picture, developing late in the postoperative course. The development of pernicious anemia in our case as in others previously reported is further evidence in support of the suggestion of Minot,8 Castle,9 Colin10 and Sturgis u that some intrinsic substance in the stomach is a factor in the prevention of pernicious anemia.In this case the response to intravenous liver extract was immediate and quite striking. The subsequent improvement and blood changes were characteristic of pernicious anemia. Desiccated hog stomach was later used instead of liver and appeared quite adequate in maintaining the blood count and the patient's general well being. SUMMARY We have reported a case of chronic gastritis, probably syphilitic, in which the patient has lived five years after a total gastrectomy with the development of pernicious anemia about three years after the operation. She has responded satisfactorily to liver extract and desiccated hog stomach.

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